2022 EULAR points to consider for remote care in rheumatic and musculoskeletal diseases

Abstract

BackgroundRemote care and telehealth have the potential to expand healthcare access, and the COVID-19 pandemic has called for alternative solutions to conventional face-to-face follow-up and monitoring. However, guidance is needed on the integration of telehealth into clinical care of people with rheumatic and musculoskeletal diseases (RMD).ObjectiveTo develop EULAR points to consider (PtC) for the development, prioritisation and implementation of telehealth for people with RMD.MethodsA multidisciplinary EULAR task force (TF) of 30 members from 14 European countries was established, and the EULAR standardised operating procedures for development of PtC were followed. A systematic literature review was conducted to support the TF in formulating the PtC. The level of agreement among the TF was established by anonymous online voting.ResultsFour overarching principles and nine PtC were formulated. The use of telehealth should be tailored to patient’s needs and preferences. The healthcare team should have adequate equipment and training and have telecommunication skills. Telehealth can be used in screening for RMD as preassessment in the referral process, for disease monitoring and regulation of medication dosages and in some non-pharmacological interventions. People with RMD should be offered training in using telehealth, and barriers should be resolved whenever possible.The level of agreement to each statement ranged from 8.5 to 9.8/10.ConclusionThe PtC have identified areas where telehealth could improve quality of care and increase healthcare access. Knowing about drivers and barriers of telehealth is a prerequisite to successfully establish remote care approaches in rheumatologic clinical practice.

Remote self-collection of capillary blood using upper arm devices for autoantibody analysis in patients with immune-mediated inflammatory rheumatic diseases

“…In line with EULAR’s research agenda for patient self-management 30 and remote care, 31 we aimed to evaluate the accuracy, feasibility, usability and acceptability of two UA self-sampling devices (Tasso+ and TAP II) in patients with IMRD for measurement of autoantibodies and CRP levels.…”

Novel insights into the management of rheumatoid arthritis: one year in review 2022

“…No substantial differences between those followed by telemedicine only (n=121) and those who performed at least one in-person visit (n=76) were observed when multiple PROs (general health [GH], visual analogue scale [VAS] pain, functional assessment of chronic illness therapy [FACIT], rheumatoid arthritis disease activity index [RA-DAI], recent onset arthritis disability [ROAD], and PRO-CLinical ARthritis Activity [PROCLARA]) were considered. While awaiting for evidence to accumulate, a list of points to consider on remote care has been recently published by the EULAR to guide the implementation of telehealth for people with rheumatic diseases (49). Tailored care combining remote and face-toface attendance on the basis of shared decision-making and patient preference was stated as the first overarching principle.…”

“…• Small observational studies consistently showed that telemedicine interventions were not associated with worse PROs compared to usual care or harm to patients, but interventions were heterogeneous as well as the measured outcomes. A guidance on remote care in rheumatic diseases has been published by the EU-LAR and telemedicine may assist pre-diagnostic processes, monitoring, and some non-pharmacological interventions (49). • ML applications in the field of rheumatology are growing and it is important to gain confidence with this powerful new analytics tool.…”

Machine learning-based improvement of an online rheumatology referral and triage system

“…In contrast to emergency medicine (5), no objective, rheumatology triage criteria exists and this lack of standardized triage decisions hampers quality of care. The European Alliance of Associations for Rheumatology (EULAR) recently emphasized the added value of patient preassessment by telehealth to improve the referral process to rheumatology and help prioritization of people with suspected IRD (6).…”